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NPI Code Detail

MEDICARE: LONG TERM CARE SPECIALISTS INC

MEDICARE: LONG TERM CARE SPECIALISTS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility330896MN

General Provider Information

NPI Number : 1255424115
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONG TERM CARE SPECIALISTS INC
Provider Business Mailing Address
First Line : 512 49TH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55430-3621
Country : US
Telephone Number : 612-529-7747
Fax Number : 612-607-5821
Provider Business Practice Location Address
First Line : 512 49TH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55430-3621
Country : US
Telephone Number : 612-529-7747
Fax Number : 612-607-5821
Authorized Official
Title or Position : ADMINISTRATOR PRESIDENT
Name : MR. ROBERT DEAN LETICH
Credential : LHNA LSW
Telephone Number : 612-529-9152
Provider Enumeration Date : 10/02/2006
Last Update Date : 01/18/2008

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Directions to “LONG TERM CARE SPECIALISTS INC ” Practice Location

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